Swelling but very little pain at the costosternal joint

by Victoria

Swelling but very little pain at the costosternal joint still need to be assessed, like any other condition, if it continues for any length of time.

About 9 months ago I noticed twinges I was getting in my chest around the right rib area (maybe the third rib) on my right side. The pain would come and go and would be very mild for 5-20 seconds about twice a week.

Then I started to notice the pain more often, to the point where it got to be every day and I noticed swelling in my rib area on my right side, by where the rib meets the joint. I wasn't sure what was causing it but thought it may be from picking up and holding on my hip my 20lb toddler on my left hip was somehow causing pain in my right chest/rib.

I stopped picking him up and about 6-8 weeks later the pain got less and less frequent but the swelling stayed. It got to the point where I was having no pain at all. Just the swelling was there. If I pushed on the joint area it was tender.

Last weekend I picked up my toddler a few times and noticed the area hurt again the next day. The pain was and always has been very mild. I would say 1 or 2 on a pain scale.

I have felt the pain on and off this week, the swelling is there and extends to my rib area too, past the joint and up toward my armpit, about two inches in length. I assume it is swelling but I don't know.

I feel the swelling more if my arm is raised.

I haven't taken anything for this and wasn't sure if I should just wait it out.

Thank you!

Good morning Victoria, and thank you for your letter.

It certainly sounds like you have a mild dose of Tietze's syndrome; simply because you've had this for several months, I would recommend you have the whole area examined.

Because it's in the area around your breast and extending towards the armpit, I'd recommend you start with a consultation with your medical doctor, just to be sure there's nothing else going on.

Research shows anti inflammatory tablets won't help the chest pain, so don't accept any.

Then any ongoing joint pain needs to be evaluated by your chiropractor; the difficulty is that this is a nuggety chronic condition that can be very severe, and many of my colleagues have probably never heard of it. I hadn't until I'd been in practice for some 25 years.

And, please note this, a heavy chiropractic manipulation in the middle of the back will worsen it. So you need to find the right person, and talk very forthrightly about it; until I understood the condition, I aggravated numerous cases, and you don't want to be a victim! It's called iatrogenic disease, the third most common condition; doctor-caused illness.

Don't by put off by these comments, but it does mean you have to find a chiropractor knowledgeable about Tietze's syndrome and will treat you more gently; the 'anterior thoracic' adjustment is the treatment of choice. Ask before making an appointment. If you read the other letters on the subject you'll soon realise it can become very severe; rather nip it in the bud.

Alternating ice and heat, as in the shower, and gentle massage of the area helps too. If carrying your child on the hip seems to be an aggravating factor, then certainly avoid it where possible.

Good luck, and I hope this contributes. Fire away if you have any more questions.

Read 'find a good DC' in the navigation bar at chiropractic help.

Dr B

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.

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